The Columbia Center for Children's Environmental Health (CCCEH), the New York City Department of Health and Mental Hygiene (NYCDOHMH), and the New York City Housing Authority (NYCHA) plan to continue our collaborative research to assess whether a building-wide, integrated pest management (IPM) program in public housing is an effective alternative to the regular application of aerosol pesticides. NYCHA has hired and trained community residents to become licensed pest control operators to provide the IPM intervention, and with the support of NYCHA tenants' associations, NYCDOHMH and CCCEH are collaborating to evaluate the intervention's impact on pest populations, allergen levels, and residents' health. IPM attempts to control pests by eliminating sources of food and points of entry, and by using low-toxicity pesticides such as baits, gels and boric acid. The need for an effective, low-toxicity form of pest control in low-income minority neighborhoods has been underscored by CCCEH findings showing that in utero sensitization to cockroach allergens and exposure to pesticides used for residential pest control are widespread in the CCCEH cohort.Prenatal exposure to the pesticide chlorpyrifos has also been associated with reduced birth weight and length in these children. Further, housing-related exposures are the primary concern expressed by residents at community board meetings we attended to receive feedback on Center research. Our two proposed research projects build on our current collaboration with the city and the community and the Center's research findings. In Phase 1, we will examine the long-term success, durability, and cost-effectiveness of IPM, and in Phase 2, we will test the effectiveness of an enhanced inspection and remediation process to improve a broad range of health-related housing conditions. If successful, these interventions may be replicated citywide, and could serve as a model for other public housing agencies in cities across the United States. The specific aims are to: Aim 1. Determine the duration of lPM effectiveness by measuring (a) how long IPM keeps pest levels reduced; (b) how long the physical repairs, sealing and caulking last before degrading; and (c) the maintenance schedule needed to maintain IPM. The current study of 300 apartments (170 in East Harlem, and an additional 130 to be recruited in Bushwick, Brooklyn) will be extended past the current 6 months to 12 months post intervention. Aim 2. Determine whether a collaborative intervention by NYCHA staff and building tenants' associations can improve health-related housing conditions in NYCHA apartments by measuring (a) residents' perceptions of their overall health, housing-related quality of life, and satisfaction with NYCHA maintenance procedures; (b) control of a broad spectrum of health-related housing conditions; and (c) morbidity in residents with asthma. Additional NYCHA buildings with approximately 200 apartments will be studied. Comparison buildings will receive usual care, and intervention buildings will receive an intervention that includes annual inspection by NYCHA maintenance staff with remediation of health-related housing conditions, including pests, plumbing leaks and mold, peeling paint, smoke detection systems, window guards, and ventilation. Aim 3: Collaborate with the Community Outreach, Translation, and Application Core (COTAC) to assess health-related housing concerns of the community, translate research findings to be understood and used by community members, and assist in activities to help improve policies and practices to reduce environmental risks to children's health.